User: Guest  Login
Title:

Impact of immature platelets on platelet response to ticagrelor and prasugrel in patients with acute coronary syndrome.

Document type:
Journal Article; Research Support, Non-U.S. Gov't; Article
Author(s):
Bernlochner, Isabell; Goedel, Alexander; Plischke, Conny; Schüpke, Stefanie; Haller, Bernhard; Schulz, Christoph; Mayer, Katharina; Morath, Tanja; Braun, Siegmund; Schunkert, Heribert; Siess, Wolfgang; Kastrati, Adnan; Laugwitz, Karl-Ludwig
Abstract:
The influence of reticulated platelets (RPs) on platelet inhibition by ticagrelor when compared with prasugrel is unknown. We aimed to determine the influence of RPs on adenosine diphosphate- (ADP-) induced platelet aggregation in patients with acute coronary syndrome who were randomly assigned to receive either ticagrelor or prasugrel for P2Y12 receptor inhibition.One hundred and twenty-four patients were prospectively enrolled. The immature platelet fraction (IPF) was measured by an automated haematoanalyzer and platelet aggregation was assessed by multiple electrode aggregometry. In a subgroup of patients (n = 28) ADP-induced P-selectin expression was measured in dependence of the time point of study drug intake in RPs that were discriminated from mature platelets by thiazole-orange (TO) staining. The primary endpoint was the correlation of platelet aggregation and IPF in ticagrelor- vs. prasugrel-treated patients. Platelet aggregation significantly correlated with IPF in patients who received prasugrel (r = 0.41, P < 0.001). In contrast, no correlation between IPF and platelet aggregation was observed in ticagrelor-treated patients (r = 0.08, P = 0.51, P for difference of correlation coefficients P = 0.05). Within the TO-positive RP fraction, P-selectin expression was significantly higher in prasugrel when compared with ticagrelor-treated individuals (prasugrel 18.6 ± 16.0% vs. ticagrelor 11.5 ± 6.0%, P = 0.047). A time-dependent P-selectin expression was observed in prasugrel but not in ticagrelor-treated patients (prasugrel early 11.9 ± 9.4% vs. late 26.3 ± 19.0%, P = 0.031, ticagrelor early 9.6 ± 4.9% vs. late 13.5 ± 6.6%, P = 0.127).Reticulated platelets show a greater impact on platelet reactivity in response to prasugrel when compared with ticagrelor.
Journal title abbreviation:
Eur Heart J
Year:
2015
Journal volume:
36
Journal issue:
45
Pages contribution:
3202-10
Language:
eng
Fulltext / DOI:
doi:10.1093/eurheartj/ehv326
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/26216931
Print-ISSN:
0195-668X
TUM Institution:
I. Medizinische Klinik und Poliklinik (Kardiologie); Institut für Klinische Chemie und Pathobiochemie; Institut für Medizinische Statistik und Epidemiologie; Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
 BibTeX